Low PrEP Awareness and Use Among People Who Inject Drugs, San Francisco, 2018

McFarland, Willi; Lin, Jess; Santos, Glenn-Milo; Arayasirikul, Sean; Raymond, Henry F.; Wilson, Erin C.

doi:10.1007/s10461-019-02682-7

Cited by 41 publications

(38 citation statements)

References 9 publications

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“…In urban areas, although PrEP awareness and use among MSM has increased, PrEP use remains lower among Black and Latinx MSM [13]. Lastly, PrEP awareness and use is critically low among persons who inject drugs [14][15][16][17].…”

Section: Prep Awareness and Usagementioning

confidence: 99%

Pre-exposure Prophylaxis (PrEP) Information on Instagram: Content Analysis

Walsh‐Buhi¹,

Houghton²,

Lange³

et al. 2021

JMIR Public Health Surveill

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Background There is still an HIV epidemic in the United States, which is a substantial issue for populations bearing a disproportionate burden of HIV infections. Daily oral pre-exposure prophylaxis (PrEP) has proven to be safe and effective in reducing HIV acquisition risk. However, studies document that PrEP awareness/usage is low. There is also limited understanding of social media platforms, such as Instagram, as PrEP information sources. Objective Given the paucity of research on PrEP-related Instagram posts and popularity of this social media platform, the purpose of this research is to describe the source characteristics, image types, and textual contents of PrEP-related posts on Instagram. Methods Using Crowdtangle Search, a public insights tool owned/operated by Facebook, we retrieved publicly accessible and English-language-only Instagram posts for the 12-month period preceding April 22, 2020, using the following terms: Truvada or “pre-exposure prophylaxis” or #truvada or #truvadaprep or #truvadawhore or #truvadaforprep. We employed a qualitative coding methodology to manually extract information from posts. Using a pretested codebook, we performed content analysis on 250 posts, examining message and source characteristics (ie, organization type [eg, government, news] and individual type [eg, physician]), including information about PrEP (eg, how it works, cost), and indicated users. Frequencies and percentages were calculated for all categorical variables. A Chi-square test was conducted to determine differences between source types on a variety of message characteristics. Results Three-quarters of the posts (193/250, 77.2%) were posted by organizations. Of the 250 posts reviewed, approximately two-thirds (174/250, 69.6%) included a photograph, more than half (142/250, 56.8%) included an infographic, and approximately one-tenth (30/250, 12%) included a video. More than half defined PrEP (137/250, 54.8%), but fewer posts promoted PrEP use, explained how PrEP works, and included information on the effectiveness of PrEP or who can use it. The most commonly hashtagged populations among posts were men who have sex with men (MSM), but not necessarily bisexual men. Few posts contained race-/ethnicity-related hashtags (11/250, 4.4%). Fewer posts contained transgender-associated tags (eg, #transgirl; 5/250, 2%). No posts contained tags related to heterosexuals or injection drug users. We found statistical differences between source types (ie, individual versus organization). Specifically, posts from organizations more frequently contained information about who can use PrEP, whereas posts from individuals more frequently contained information describing adverse effects. Conclusions This study is among the first to review Instagram for PrEP-related content, and it answers the National AIDS Strategy’s call for a clearer articulation of the science surrounding HIV risk/prevention through better understanding of the current public information environment. This study offers a snapshot of how PrEP is being discussed (and by whom) on one of the most popular social media platforms and provides a foundation for developing and implementing PrEP promotion interventions on Instagram.

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Section: Prep Awareness and Usagementioning

confidence: 99%

Pre-exposure Prophylaxis (PrEP) Information on Instagram: Content Analysis

Walsh‐Buhi¹,

Houghton²,

Lange³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…This level of awareness and use is surprising given that San Francisco has invested substantial resources toward the promotion and scale-up of PrEP as a cornerstone to reducing new HIV infections since the “Getting to Zero” goal was instituted in 2013. 10 Our estimate of 42.5% places PrEP awareness among low-income heterosexuals as the lowest of our populations prioritized for HIV prevention, well behind MSM at 97% aware, trans women at 79% aware, and PWID at 57% 5,11 in San Francisco.…”

Section: Discussionmentioning

confidence: 93%

“…The racial disparities among heterosexuals mirror those witnessed among MSM, trans women, PWID, and high-risk heterosexual women in other studies. [9][10][11]15 There are limitations to this study. Being cross-sectional, we are limited in drawing conclusions regarding causation.…”

Section: Discussionmentioning

confidence: 99%

“…21 A second strategy would be to reframe or tailor the information that healthcare workers pass on to the different populations that are indicated for PrEP since their needs and attitudes may differ from MSM, trans women, and PWID. 11,22 Targeted messaging and use of electronic media have been highlighted to improve the uptake of PrEP among MSM in other parts of the United States. 22 Such media have also been shown to be key in scaling up the use of PrEP for heterosexual populations in sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 99%

“…10 Regarding racial disparities in PrEP use, whereas there has generally been an increase in PrEP use among MSM of all races, use among Black/African American MSM remains lower than MSM of all other races. 11 Meanwhile, HIV surveillance data for the United States continue to note racial disparities in the transmission of HIV with higher rates of new diagnoses among Black/African Americans and Latinx than other racial/ethnic groups. 3,4 To the best of our knowledge, there are no data highlighting awareness and uptake among low-income, highrisk heterosexual men and women in San Francisco despite their relative increased contribution to HIV incidence in the city.…”

Section: Introductionmentioning

confidence: 99%

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Awareness and uptake of pre-exposure prophylaxis for HIV among low-income, HIV-negative heterosexuals in San Francisco

et al. 2021

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We examined pre-exposure prophylaxis (PrEP) awareness and uptake among low-income heterosexual men and women in San Francisco in 2019. Of 294 HIV-negative survey participants, 42.5% were aware of PrEP. Few women (12.5%) and men (8.9%) had discussed PrEP with a healthcare provider; 3.8% of women and 0% of men had used PrEP in the last year. White participants (adjusted odds ratio (aOR) 5.39, 95% CI 1.02, 28.56), women (aOR 2.19, 95% CI 1.30, 3.70), and age 60 years or above (aOR 4.00, 95% CI 1.12, 14.34) had greater odds of being aware of PrEP. Testing for HIV or sexually transmitted infection in the past year was marginally associated with a greater PrEP awareness. Our findings reveal gaps in PrEP implementation associated with social disparities among low-income heterosexuals. Testing services and targeted promotional and educational materials are needed lest high-risk, low-income populations are left behind in San Francisco’s aggressive “Getting to Zero” efforts.

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The Stigma Struggles of Biomedical Progress: Understanding Community Engagement with PrEP by People Who Use Drugs

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2021

Social Aspects of HIV

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Low PrEP Awareness and Use Among People Who Inject Drugs, San Francisco, 2018

Cited by 41 publications

References 9 publications

Pre-exposure Prophylaxis (PrEP) Information on Instagram: Content Analysis

Pre-exposure Prophylaxis (PrEP) Information on Instagram: Content Analysis

Awareness and uptake of pre-exposure prophylaxis for HIV among low-income, HIV-negative heterosexuals in San Francisco

The Stigma Struggles of Biomedical Progress: Understanding Community Engagement with PrEP by People Who Use Drugs

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